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ZABBYS SOLID SILICONE SPHERE IMPLANT 18MM ZSS-18

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ZABBYS SOLID SILICONE SPHERE IMPLANT 18MM ZSS-18

INTRODUCTION

Every human being deserves good look. Alter evisceration the sclera and muscles contract and shrink. The contour of eye is lost. The artificial eye prosthesis, worn later on, will always look artificial due to lack of eye movements. If evisceration has been done in childhood the eye socket may not develop to full size and a bony deformity may occur. The purpose of solid silicone eye sphere is to maintain contour of eyeball, maintain the eye movements, provide a base for prosthesis, and maintain shape of eye socket and to prevent bony deformity. Lastly, but not the least, to give full self-confidence to the patient. It gives excellent cosmetic results. The artificial eye prosthesis, to be worn later on, will look natural due to good eye contour and almost full eye movements. The solid eye sphere is made of medical grade silicone elastomer. It is molded in one piece.

CONTRAINDICATIONS

Like all implants, it is contraindicated in cases where active infection or inflammation is present. Preferably it should be inserted after six months to one year of subsidence of inflammation.

PRECAUTIONS

Prior to surgery, prospective patients and or their representative should be informed of the possible complications associated with the use of this product.

OPERATIVE PROCEDURE

The implantation of silicone eye sphere may be accomplished through variety of procedures. The choice depends upon the training of surgeon, customs in that hospital, country. Therefore the surgeon is best advised to use method, which his/her own practice and training dictate to be best for the patient. Following procedure is to act as guideline only. Insertion of silicone Eye sphere is done after completion of evisceration of eye and before closure of sclera and conjunctiva. Evisceration is done on standard lines. A proper size of silicone Eye sphere is selected.

The silcone Eye sphere is inserted in the scleral cup. The edges of sclera are sutured in the lateral line with interrupted vertical inverting mattress sutures. To avoid "dog ear" projections of sclera at each end of the sutured line, a triangle of sclera is excised from each end with the bases towards the center.

An alternative procedure is to make from the limbus four radial scleral incisions about 5 mm long at 1.30,4.30, 7.30 and 10.30 o'clock when silicone Eye sphere is in place, two chromic catgut mattress sutures approximate the medial and lateral scleral flaps and two chromic catgut sutures join the upper and lower flaps. In case of enucleation, cadaveric preserved sclera is used. Silicone Eye sphere is put into the pouch of sclera. The pouch is properly stitched from all sides. It is placed inside the eye socket. Four recti are stitched on four side with scleral pouch. Tenon's capsule is sewn over this with horizontal line of interrupted 1 metric (6/0) chromic catgut sutures and the conjunctiva with continuous key pattern suture of 0.5 metric (8/0) chromic catgut.

POSTOPERATIVE MANAGEMENT

The patient may be mobilized early. On the first postoperative day the conjunctival sac is irrigated. The firm pressure dressing is maintained for 2 days, when the socket is dressed. This may be re applied with daily dressings until the fifth day. An acrylic shell may be placed in the conjunctival sac and a convex black eye shade, lined with sheet of lint, the smooth side opposed to the socket, is applied. The acrylic shell, approximately the shape and size of prostheses to be fitted later, helps to reduce the edema of the conjunctiva and to maintain the appropriate size and shape of the socket. A prosthesis is fitted in the third or fourth week of operation. Pain may be severe for two three days and chemosis may take up to three weeks to subside.

COMPLICATIONS

Complications which may result from the use of this product include the risks associated with the medication and methods utilized in the surgical procedure, as well as patients response, reaction or degree of intolerance to any foreign object implanted into the body.

The medical literature is full of hazards and complications associated with use of hydroxyapatite Eye Sphere. It is implied & understood that since user is highly trained super specialist. he has experience The main complications of use of a silicone Eye sphere are infection and expulsion. To prevent infection, use of implant should be avoided with active inflammation. Suitable antibiotic cover should be given during and after implantation.